To observe and to compare the safety and effectiveness after laparoscopic and open surgery in treating T4a colon cancer.

243 patients with colon neoplasms who underwent surgical treatment from April 2016 to October 2018 were enrolled and divided into the laparoscopic group (94 cases) and the laparotomy group (149 cases). Statistical analysis were performed by using SPSS23.0 software, the comparison of postoperative complications within 30 days and postoperative effect after 3 years were examined by using χ² test; Intraoperative postoperative indicators were expressed as (±s), and were examined by using independent t test. A P value of <0.05 was considered as statistically significant difference.

In laparoscopic group, the intraoperative blood loss, length of incision, postoperative defecation time, drainage tube removal time, feeding fluid time, urinary catheter removal time, and the time of postoperative hospitalization were less than those in the laparotomy group respectively (P<0.05); the operative time of the laparoscopic group was more than that of the laparotomy group (P<0.05), however with no difference of the harvested lymph nodes (P>0.05); the complication rate of the 30-day in postoperative laparoscopic group (7.4%) was lower than 16.8% in the laparotomy group (P<0.05). Follow-up time ranged from 6 to 36 months, with an average of 18.3 months. There were no statistically significant difference between two groups in terms of local recurrence of 4.3% and 5.4%), distant metastasis, of 5.3% and 4.7% and mortality of 9.6% and 10.1% respectively (P>0.05).

The short-term clinical outcome of patients with T4a colon cancers is much more better after laparoscopic surgery, wtih less pain, faster recovery and less postoperative complication, compared with laparotomy surgery.